Angina

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Angina explained

Angina, sometimes called angina pectoris, is a symptom. It’s a pain or an uncomfortable feeling when blood flow to your heart is reduced. It's not dangerous but it can be a sign of heart problem like coronary heart disease.

Angina symptoms

Angina feels different for everyone. It can feel like pressure, tightness or squeezing in your chest. This can feel painful or like a dull ache. You might also feel it in your shoulders, arms, neck, jaw, back or stomach.  

• very tired (fatigue)
• dizziness
• sweating
• feeling sick
• shortness of breath.

Angina symptoms in women

Both men and women can experience the same symptoms of angina. These include ‘classic’ chest pain, and pain in the jaw, arms, shoulders, neck, back or tummy.  

But in general, women are more likely than men to develop:

• less common symptoms like feeling sick, sweaty, dizzy and breathless
• microvascular angina, spasms in the smallest coronary arteries.

Knowing all the symptoms will help you get the treatment you need quickly. 

If you experience any of these symptoms, speak to your doctor as soon as possible.

Types of angina

There are several types of angina including: 

Stable angina

This is the most common type of angina. It tends to happen when your heart works harder, such as when you’re walking uphill, and goes away when you rest. 

You’ll usually know when it’s likely to happen and the pain or discomfort is similar to what you’ve had before. 

Stable angina lasts 5 minutes or less, and improves if you rest or take your medicine. 

Unstable angina 

Unstable angina can feel different to your normal angina symptoms. It can happen even when you’re resting. Unstable angina feels more severe and lasts longer. Your symptoms might not improve when you rest or take medicines. 

If your symptoms do not improve when you rest or take medicines, you should call 999 immediately. 

Vasospastic angina 

Also known as coronary artery spasm or Prinzmetal’s angina, Vasospastic angina is rare. It can happen during the night when you’re resting, when a coronary artery supplying blood and oxygen to your heart goes into spasm and narrows or tightens, and lets less blood through.

Microvascular angina

Microvascular angina (also known as cardiac syndrome X) usually happens when you're under physical pressure, like when you're exercising, or you’ve been stressed or anxious. The pain is often caused by spasms in the smallest coronary arteries restricting blood flow.  

Causes of angina

The most common cause is coronary heart disease. This is when the arteries that supply your heart muscle with blood and oxygen are narrowed by a fatty substance called plaque. It means less blood flows to your heart muscle and can cause angina symptoms. 

There are common triggers for angina pain, like:

• physical activity
• emotional stress
• cold weather
• eating a meal.

The symptoms usually stop after a few minutes. Panic attacks or feeling anxious can cause chest pain. If you experience this, it isn’t angina. Anxiety isn’t caused by a problem with your blood flow, whereas angina is.

Angina after eating 

Eating a big meal can trigger angina symptoms. Sometimes people confuse angina with indigestion. If meals are making your angina worse, try having smaller portions, more often throughout the day.

Risk factors for angina

There are several risk factors that can increase your risk of coronary heart disease and angina. They include:

• stress
• smoking
• diabetes
• obesity
• high cholesterol
• high blood pressure
• family history of heart disease
• older age (45+ for men and 55+ for women).

Is angina hereditary?

No, angina is not an inherited condition.

It won’t be found in a genetic test. But if your grandparents, parents, siblings or children have angina then you have what’s called a strong family history of the condition. This can increase your chance of developing a heart condition that could cause angina too.

Find out more about family histories of heart conditions and how you can reduce your risk.

Diagnosing angina

Your doctor may be able to tell whether you have angina from your symptoms. Or, they may want to do a health check or send you for some tests such as:

• an ECG
• coronary angiogram
• heart scan.

Treating angina

• Medicine, such as nitrate sprays, patches and pills may help control your symptoms. Your doctor might also suggest you take medicine to reduce your risk of a heart attack or stroke.
• Some people need treatments such as a coronary angioplasty where a special kind of balloon is gently inflated to open a narrowed artery. Many people also have a type of mesh called a stent inserted to keep the artery open.
• Heart bypass surgery may also be an option. Simple lifestyle changes may help reduce your symptoms of angina, improve your overall health and reduce your risk of a heart attack in the future.

Can I cure my angina?

Your doctor will prescribe you medication that will improve symptoms and help your heart to function better. But a change in lifestyle will help prevent more fatty substance called plaque forming in your arteries and improve your symptoms of angina.

Try our lifestyle tips to see some improvements:

• Quit smoking. Smoking can cause arteries to become clogged; this can make angina symptoms worse.
• Control high blood pressure. Take your medication if you need it, and check out our low salt recipes.
• Eat a healthy balanced diet by choosing options that are lower in saturated fat and swapping unhealthy snacks for more nutritious options.
• Reduce your cholesterol level with your medicine and follow our tips on the right fats to eat.
• Get active. Try our easy My Step Challenge and see how else you can increase your activity.
• Manage a healthy weight with our healthy eating toolkit.
• Find ways to manage stress. Stress can bring on angina symptoms. Our supporters tell us regular yoga or meditation can really work.
• Control your blood glucose if you have diabetes. We have lots of information to help you manage your diabetes.
• Enjoy alcohol in moderation.

Living with angina

Many people with angina have a good quality of life and continue as usual.

Living an active lifestyle is also really important to help stop your underlying coronary heart disease from getting worse. Your doctor or nurse can tell you if you need to make any changes to your routine and make specific lifestyle changes.

More information and support

If you need more information or just want to talk to someone, we’re here for you:

• talk to one of our cardiac nurses by calling our Heart Helpline
• read about the future of angina treatments.